Definition

De Quervain's tenosynovitis is an irritation of tendons that run from the wrist to the thumb. These tendons pass through a tunnel-like tissue, called a sheath, at the wrist. The tunnel area can cause additional pressure and irritation on thickened or swollen tendons, making normal movements very painful.

De Quervain's Tenosynovitis

Causes

De Quervain’s is caused by pressure on already irritated tendons as they move through the sheath at the wrist. The irritation of the tendon may be caused by repetitive movements of the thumb and wrists or a direct blow to the area.

Risk Factors

De Quervain's tenosynovitis is more common in women. Activities that may increase your chance of getting de Quervain's tenosynovitis include:

Knitting and needlepoint

Lifting a baby or young child often

Bowling or wrestling

Jobs involving twisting of the wrist or driving of screws

Excessive gaming that involves small movements of thumb or texting

Symptoms

Symptoms may include:

Pain or tenderness at the base of the thumb

Pain when pinching

Swelling over the thumb side of the wrist

A snapping or catching sensation when moving the thumb

Numbness on the back of the thumb, spreading to the index finger

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done and your doctor will ask you to move your fingers and wrists in different ways to help make the diagnosis.

Your doctor may ask you to make a fist with your thumb inside your fingers and bend your wrist toward your little finger. If this causes pain at the wrist below your thumb, you may have de Quervain's tenosynovitis.

Treatment

The goal of treatment is to relieve pain and help you regain function. Initial steps to reduce swelling and irritation include:

Resting the thumb and wrist

Applying ice

Avoiding activity that causes the pain

A thumb splint to support and allow the wrist to rest

Medication such as nonsteroidal anti-inflammatory drugs (NSAIDs)

If conservative treatments above does not provide adequate relief, your doctor may recommend:

Cortisone injection—a cortisone medication is injected into the area to reduce swelling

Surgery—if all else fails, surgery may be done to open the tunnel that the tendon is passing through

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